Parents' and health professionals' perspectives on supporting physical activity among children undergoing cancer treatment: A qualitative interview study.
Abstract
Purpose
Physical activity (PA) opportunities are not consistently integrated into childhood cancer care. This qualitative study explored parents' and health professionals' perspectives on barriers and facilitators to supporting PA during treatment, including areas of convergence and divergence.
Methods
Semi-structured interviews were conducted with 27 participants (10 parents, 17 health professionals). Participants were recruited through consumer advisory panels, community organisations, and social media. Interview questions were informed by the RE-
Aim
framework, and data analysed using codebook thematic analysis to categorise common patterns while considering differences between participant groups.
Results
Participants described PA as frequently deprioritised during treatment, when children experienced treatment-related symptoms and reduced functional capacity. Concerns about safety, infection, medical devices and appropriate PA intensity further limited participation. Facilitators included clinical endorsement, education, early referral and flexible programs adapted to treatment stage, symptoms, preferences and functional capacity. Telehealth, community-based options, enjoyable activities, supervised and self-directed PA were also considered valuable. Organisational barriers included limited staffing, space, referral pathways, funding and access to appropriately trained exercise professionals. Parents and health professionals converged on the value of PA and the need for safe, tailored support, but differed in their emphasis on family capacity, clinical priorities and system-level constraints. Parents emphasised family burden, whereas health professionals emphasised service capacity and clinical priorities.
Conclusion
Participants' perspectives highlight the need for flexible, safety-informed and accessible PA pathways integrated into routine care, supported by appropriate workforce capacity and resourcing, and adapted to changing treatment needs. Considering both stakeholder groups can inform more responsive PA implementation strategies.